Grand Rounds August on Arkansas Medical News Inc.

Grand Rounds August

Northwest Health System to launch The Heart Hospital Network

SPRINGDALE — Northwest Health System is taking heart and vascular care to the next level by establishing The Heart Hospital Network – Northwest Health System, a "virtual hospital" model designed to align and expand cardiovascular care in the Arkansas-Oklahoma-Missouri region.

This physician-led "virtual hospital" model will integrate cardiovascular services at Northwest Health System's hospitals in Springdale and Bentonville under the new identity of The Heart Hospital Network. Northwest has committed a significant investment in new equipment, software and facility renovations to make The Heart Hospital Network a reality. Initially, the project calls for the designation of a significant portion of the Springdale hospital's north patient tower (Tower 1) and the Bentonville hospital's cardiovascular services as core components of The Heart Hospital Network.

"Our goal is to integrate our efforts and resources to create a heart and vascular program that is comparable, if not superior, to those found at the most prestigious heart and vascular centers in the Arkansas-Oklahoma-Missouri region and the nation," said Northwest Health System CEO Doug Arnold, in announcing the new venture. "When I came here as CEO in August, one of the first things I noted is that a metro area the size of Northwest Arkansas deserves a top-quality cardiovascular service like this. When I shared that observation with our Cardiologists and Cardiothoracic Surgeons, I found kindred spirits. Northwest Health System and its affiliated physicians have been leaders in heart and vascular care over the years. In fact, Northwest Health System performed the region's first open-heart surgery in 1986. So it's fitting that Northwest Health System take the lead on a heart and vascular care concept that is the logical next step for a metropolitan area of the size and level of sophistication found in Northwest Arkansas."

The Heart Hospital Network, initially will include Northwest Health System's Springdale and Bentonville hospitals, as well as Siloam Springs Memorial Hospital. The network is expected to provide care to residents from a large portion of Arkansas, Oklahoma and Missouri.

The heart hospital network model, which is physician-driven, unifies various services related to heart and vascular care. It is designed so that related departments flow together to create a synergy that results in a more "seamless" delivery of care. This model streamlines care to create maximum proficiency, following "best-practice" processes, with the patient and family at the center of it all.

The Heart Hospital Network's initial development involves the dedication of significant portions of the north patient tower (Tower 1) at the Springdale hospital, unifying closely related departments. Following is a sampling of the affected departments:

1st Floor – Cardiac Catheterization Labs, Surgery and Surgery Recovery
2nd Floor – Coronary Care Unit (CCU) and other Intensive Care Units (ICUs).
3rd Floor – Pre/Post-Surgery/Procedure and heart/vascular patient rooms (all private).
5th Floor – finished space for future expansion. The 5th Floor currently has Guest House facilities for patients' families.
In addition, a diagnostic cardiac catheterization lab will be installed in a new cardiac outpatient center in the Jones Clinic tower, providing the physicians greater capacity and access to perform diagnostic cardiac catheterizations, etc.

The heart program at the Bentonville hospital will be included as an integral part of The Heart Hospital Network. Process improvements derived from this new "virtual hospital" concept will be applied system-wide, to ensure that heart and vascular care is elevated throughout the Northwest Health System. The highly specialized Cardiac Electrophysiology Intervention Program will also be based at the Bentonville campus, treating atrial fibrillation and other arrhythmic disorders.

The combined resources of Northwest's unified heart and vascular program (with three cardiovascular operating rooms and six cardiac catheterization labs), gives Northwest Health System the largest capacity of any such program in Northwest Arkansas.

The Heart Hospital's leadership:

Jonathan Clopton Ph.D., RT (R), RCIS, has been named Cardiovascular Service Line Administrator for Northwest Health System and will oversee the day-to-day operations of The Heart Hospital Network and all other heart and vascular services throughout Northwest Health System.

Dr. Clopton, who is a Registered Radiologic Technologist and a Registered Cardiovascular Invasive Specialist, holds a bachelor's degree in Radiography from the University of Central Arkansas in Conway; a master's degree in Radiologic Science from Midwestern State University in Wichita Falls, Texas; and a doctorate in Health Administration from Kennedy-Western University in Agoura Hills, Calif.

His healthcare career includes positions in Arkansas (Fort Smith, Springdale and Arkansas Heart Hospital in Little Rock). The Heart Hospital Network, like Arkansas' first free-standing diagnostic cardiac catheterization lab (where Dr. Clopton worked during his tenure in Little Rock), will be designed to optimize patient flow, satisfaction and outcomes.

Prior to being named Cardiovascular Service Line Administrator for Northwest Health System in April, he had served as Director of Cardiac Services at Northwest Medical Center – Springdale.

Technology and information will be primary drivers of quality-management in The Heart Hospital Network's efforts to establish itself as one of the leading heart and vascular programs in the state and region. A few key elements:

The Heart Hospital Network will monitor quality through participation in national registry databases that allow it to benchmark itself with other participating hospitals throughout the nation and glean best-practices from other top-performing programs. At present, no other heart and vascular program in Northwest Arkansas participates in these respected national registry databases.
The Heart Hospital Network also will work with the American Heart Association (AHA) to become a "Get with the Guidelines" program. The "Get with the Guidelines" initiatives align the hospital with the AHA goals for providing top-quality cardiac care. Currently, no heart and vascular service in Northwest Arkansas participates in this AHA program.
The Heart Hospital Network will obtain the prestigious Chest Pain Accreditation of the Society of Chest Pain Centers. This accreditation certifies that recipients follow the Society's high standards for management of cardiovascular patients.
A significant investment in equipment and software, including:
- An upgrade of the network's hemodynamic systems (at the Springdale and Bentonville campuses), enabling automated data abstraction, for quality-assurance and patient-safety purposes.
- Installation of two state-of-the-art new technology flat detector cardiac catheterization labs, which will provide top-quality cardiac imaging and safe intervention.
- An upgrade to an intravascular ultrasound system, which allows for visualization of vascular structures with ultrasound technology.
- An upgrade of the program's patient-monitoring and telemetry equipment, for maximized patient safety.
- Private room renovations.
- System-wide installation of an electronic EKG (electrocardiogram) management system, which allows physicians to remotely access EKG information via computers.
- Installation of a dedicated Bluetooth EKG system to support the formation of a physician-led team and regional network to improve processes surrounding the diagnosis and treatment of acute myocardial infarction (heart attack) in the region. A focal point of this effort is the deployment of a 12-lead EKG system, in cooperation with first-responder/EMS (emergency medical services) agencies throughout the region to aid in rapid diagnosis. No such network currently exists in Northwest Arkansas.

The Heart Hospital's medical staff includes some of Northwest Arkansas' most respected physicians, including:

Cardiology:

Boris Bogomilov, M.D. – Cardiologist and certified Electrophysiologist.
Joel D. Carver, M.D., FACC – Invasive/Interventional Cardiologist.
David A. Churchill, M.D., FACC, FSCAI – Invasive/Interventional Cardiologist.
Amr G. El-Shafei, M.D., FACC – Invasive/Interventional Cardiologist.
Ted J. Fish, M.D., FACC – Invasive/Interventional Cardiologist.
Michael D. Green, M.D., FACC – Invasive/Interventional Cardiologist.
James A.S. Haisten, M.D. – Invasive/Interventional Cardiologist.
Jamon R. Pruitt, M.D., FACC – Invasive/Non-Invasive Cardiologist/Interventional.
Philip Riley, D.O. – Invasive/Interventional Cardiologist.
Christopher Simpson, M.D., FACC – Invasive/Interventional Cardiologist.

Cardiovascular & Thoracic Surgery:

James C. Counce, M.D. – Cardiovascular & Thoracic Surgeon.
J. Russell Davis, M.D. – Cardiovascular & Thoracic Surgeon. Dr. Davis performed Northwest Arkansas' first minimally invasive mitral vale repair and Mini-Maze procedure for atrial fibrillation ablation.
John B. Weiss, M.D. – Cardiovascular & Thoracic Surgeon. Dr. Weiss performed Northwest Arkansas' first open-heart surgery in 1986.
Russell H. Wood, M.D. – Cardiovascular & Thoracic Surgeon.

Experienced Otolaryngologist joins Northwest Health System

SPRINGDALE — Felicia L. Johnson, M.D., a board-certified Otolaryngologist, has joined the medical staff of Northwest Health System, practicing both at Northwest Medical Center – Bentonville and Northwest Medical Center – Springdale.

Dr. Johnson received her medical education at the University of Texas Medical Branch in Galveston and then completed an internship in General Surgery and an Otolaryngology residency at the University of Oklahoma Health Sciences Center in Oklahoma City. She completed her fellowship in Laryngology and Care of the Professional Voice at Vanderbilt University Medical Center in Nashville.

In practice since 2003, Dr. Johnson comes to Northwest Health System from Little Rock, where she was the director of the Voice and Swallowing Disorders Clinic at the University of Arkansas for Medical Sciences (UAMS) and an assistant professor at Arkansas Children's Hospital for the past five years. She is a member of the American Academy of Otolaryngology, Head and Neck Surgery, the Arkansas Medical Society and the Arkansas Society of Otolaryngology.

New Report Finds Arkansas Has 10th Highest Percent of Obese Adults and Second Highest Percent of Obese and Overweight Children in the U.S.

Washington — Arkansas has the 10th highest rate of adult obesity in the nation, at 28.6 percent and the second highest of overweight youths (ages 10-17) at 37.5 percent, according to a new report by Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

The rate of obese adults remained consistent in the state in the past year. Adult obesity rates increased in 23 states and did not decrease in a single state in the past year, according to the F as in Fat: How Obesity Policies Are Failing in America 2009. In addition, the percentage of obese and overweight children is at or above 30 percent in 30 states.

Mississippi had the highest rate of adult obesity at 32.5 percent, making it the fifth year in a row that the state topped the list. Four states now have rates above 30 percent, including Mississippi, Alabama (31.2 percent), West Virginia (31.1 percent) and Tennessee (30.2 percent). Eight of the 10 states with the highest percentage of obese adults are in the South. Colorado continued to have the lowest percentage of obese adults at 18.9 percent.

Adult obesity rates now exceed 25 percent in 31 states and exceed 20 percent in 49 states and Washington, D.C. Two-thirds of American adults are either obese or overweight. In 1991, no state had an obesity rate above 20 percent. In 1980, the national average for adult obesity was 15 percent. Sixteen states experienced an increase for the second year in a row, and 11 states experienced an increase for the third straight year.

Mississippi also had the highest rate of obese and overweight children (ages 10 to 17) at 44.4 percent. Minnesota and Utah had the lowest rate at 23.1 percent. Eight of the 10 states with the highest rates of obese and overweight children are in the South. Childhood obesity rates have more than tripled since 1980

Golden Living Completes Sale of 13 Remaining Ark. Nursing Homes

Fort Smith — Golden Living has completed the previously announced sale of 13 LivingCenters and one independent living facility in Arkansas to affiliates of Capital SeniorCare Ventures, LLC, a Maryland-based company affiliated with Capital Funding Group, Inc., that owns nursing facilities in several states. The sale represents Golden Living's entire portfolio of skilled nursing facilities in the state.

Capital SeniorCare Ventures is completing this transaction through its short-term equity program, a financing mechanism that allows local operators to own their buildings within the first five years of the leasing arrangement. The 13 nursing homes and the independent living facility will be leased to 13 entities affiliated with Senior Living Communities of Arkansas, a highly regarded nursing home operator. The new operators plan to retain the current staff at each of the facilities.

"From our residents' perspective, the transaction will be transparent, because they will continue to be served by the same great staff they have come to know and trust," said Larry Deans, President of Golden LivingCenters. "In addition, the new operators will continue to utilize Aegis Therapies as their contract rehabilitation therapy provider, which will provide both the continuity and quality of care that our patients expect and deserve."

Dwight Kouri of Capital SeniorCare Ventures said, "The acquisition further strengthens our relationship with regional operators that are looking to grow. Our new Arkansas tenant/operators are experienced providers of high-quality nursing care and bring a wealth of expertise and experience to these facilities. We are very excited about this opportunity."

Deans noted that the sale does not involve or affect the Golden Living headquarters office in Fort Smith, Ark.

UAMS First in Arkansas to Use Robot to Remove Parathyroid Tumors From Patients' Chests

LITTLE ROCK – Two surgeons at the University of Arkansas for Medical Sciences (UAMS) teamed up recently to perform the first two robotic parathyroid surgeries in Arkansas.

After head and neck surgeon Brendan C. Stack Jr., M.D., diagnosed each patient's condition and found the faulty parathyroid glands in each patient's chest, heart surgeon Gareth Tobler, M.D., and Stack used the da Vinci Surgical System robot to remove the glands.

The parathyroid glands are normally in the neck, but in rare cases people are born with a parathyroid gland elsewhere in the body, such as in the chest. In these two cases, the patients' glands within the chest had developed benign tumors that were secreting excessive hormones. The hormones were leaching calcium from the patients' bones and would have caused osteoporosis if left untreated.

Tobler and Stack removed the defective glands in surgeries one week apart. "We actually use the "c" word – cured; these procedures have a 97 percent cure rate," Stack said. Removing one parathyroid gland leaves patients with three other parathyroid glands to regulate the amount of calcium in the blood and in the bones, Stack said.

The defective parathyroid was deep in the chest of each patient, so the only way to get to it was either by cutting through the breastbone or endoscopically, a common minimally invasive approach at UAMS, said Stack. "In this case, we chose the minimally invasive approach with the added advantages of the robot."

The robot gives surgeons a magnified, high-resolution 3D view inside the body and more precise control of surgical instruments. Surgeons operate the robot while sitting a few feet from the patient.

Several UAMS surgeons have become first or among the first nationally to use the robot for various surgical procedures since it was purchased in September 2007. The robot requires only small incisions, which heal quickly, allowing patients to resume normal activities weeks and even months sooner than after more traditional surgeries.

Less than a week after her robotic surgery, Kelli Murphy, 32, of Little Rock, said she was recovering quickly and already looking forward to running again, even training for the Little Rock Marathon next spring.

Harding College Of Pharmacy Receives Candidate Accreditation

SEARCY — Harding University's College of Pharmacy has been advanced to candidate accreditation status by the Accreditation Council for Pharmacy Education.

The college will maintain accreditation for the standard two-year term through June 30, 2011. Candidate status is the second step leading to full accreditation. All colleges of pharmacy in the U.S. must be accredited by ACPE.

ACPE requires pharmacy programs to participate in an onsite campus visit with council officials and provide documentation that the program meets all 30 of the accreditation standards. The six categories for standards are mission planning and evaluation, organization and administration, curriculum, students, faculty and staff, and facilities and resources.

Byron Erstine, D.O. has joined the Ear, Nose, & Throat Department Cooper Clinic

Byron Erstine, D.O. has joined the Ear, Nose, & Throat Department of Cooper Clinic. His practice is located at the main Cooper Clinic location at 6801 Rogers Avenue in Fort Smith. Dr. Erstine completed his Otolaryngology/ENT residency at Mount Clemens General Hospital in Mount Clemens, Michigan. He earned his medical degree from the University of Health Sciences, College of Osteopathic Medicine in Kansas City, Missouri where he graduated Summa Cum Laude. Cooper Clinic is a physician-owned multi-specialty group with doctors in 25 specialties/subspecialties at 17 locations.

Saline Memorial Expands Services For Hospitalized Patients

Benton — In an effort to improve access to the lifesaving benefits of kidney dialysis, Saline Memorial Hospital recently developed an inpatient dialysis program. Under the direction of physicians from Nephrology Associates, SMH will operate an inpatient dialysis unit in two designated locations within the hospital.

Highly specialized patient care will be provided 24 hours a day, 7 days a week. The unit will be staffed with experienced, licensed nurses who have received training in hemodialysis procedures, nutritional issues associated with acute renal failure and adverse reactions during hemodialysis.

St. Bernards Official Chosen President-elect of Arkansas Chapter, Health Physics Society

Brad Doney, manager of St. Bernards Nuclear Medicine and Positron Emission Tomography (PET) Imaging departments, has been elected president-elect of the Arkansas Chapter of the Health Physics Society. He is a plenary member of the organization.

Doney serves as the radiation safety officer for St. Bernards Healthcare. He is one of only 11 Arkansas who hold membership in the organization and is the only one in Northeast Arkansas.

Born and reared in St. Louis, he earned a bachelor of science degree in nuclear medicine from the University of Central Arkansas and a certificate in nuclear medicine from Baptist School of Allied Health in Little Rock. He is a board certified, licensed and registered nuclear medicine technologist who has served in the Navy and the Marine Corps.

He successfully completed radiation safety courses and is a certified Level 1 hazardous materials first responder with the Arkansas State Emergency Response Commission. He formerly served as chief nuclear medicine technologist for Numed Inc at medical facilities in Cherokee village, Walnut Ridge, Hayti, Mo., and West Plains, Mo.

He has served as manager of nuclear medicine as well as manager of positron emission tomography (PET) for St. Bernards Medical Center since 2004. He is a graduate student in the department of health, safety and environmental sciences at Indiana State University in Terre Haute and is a member of the American Society of Nuclear Cardiology.

UAMS-Northwest Receives $1 Million from Walmart Foundation

LITTLE ROCK – Preparations for medical and pharmacy students at the University of Arkansas for Medical Sciences' (UAMS) satellite campus in Fayetteville received a boost today with a $1 million grant from the Walmart Foundation.

The funds from the Bentonville-based retailer will be used to renovate the first floor of the former Washington Regional Medical Center hospital building into conference space and classrooms as well as a clinical skills training center for the UAMS Colleges of Medicine and Pharmacy.

The first group of students to attend UAMS-Northwest, six third-year medical students, will begin clinical rotations at the satellite campus in July. In the past year, 17 senior pharmacy students completed the majority of their clinical rotations at pharmacies in the region with more expected in the region during the 2009-2010 academic year.

Eventual enrollment at the satellite campus is expected to be between 250-300 with students in medical, pharmacy, nursing and allied health programs, along with resident physicians who will be serving residencies at area hospitals and clinics.

The campus also will be the new home for the UAMS Area Health Education Center (AHEC) Northwest, which provides medical care to patients in its family medical clinic and continuing education programs to health care professionals from across the region.

The AHEC, which includes family medicine resident physicians and allied health programs in radiologic technology and sonography, is expected to move to the satellite campus by the end of 2009.

Peter O. Kohler, M.D., vice chancellor for UAMS Northwest Arkansas Region said, "The satellite campus will allow us to increase our enrollment in a way not possible on our Little Rock campus.

"For medical education, we need not just conference rooms but hospitals, medical clinics and pharmacies willing to host our students for real-world experience," Kohler said. "The support we have received from physicians, pharmacists and other health care professionals in northwest Arkansas has been extremely helpful. Their mentoring of our students will complement the clinical family practice, pediatric, geriatric and psychiatric clinics and centers UAMS already operates in this part of the state."

The UAMS College of Nursing will collaborate with the University of Arkansas Department of Nursing to educate more advanced degree nurses to provide health care or serve as faculty members for schools of nursing around the state.

Renovations of the former hospital building began earlier this year. The work is focused on creating classrooms, offices, teaching labs and other resources needed to support the satellite campus.

In 2008, more than $3 million was pledged toward the UAMS expansion. In October, the Care Foundation Inc. of Springdale gave $500,000 toward development of the satellite campus. In November, a trio of Arkansas philanthropists gave a total of $1.5 million toward the effort: $500,000 each from Don Tyson and the Tyson Family Foundation, the Willard and Pat Walker Charitable Foundation, and Johnelle Hunt. That gift was announced two days after a $300,000 gift to the project from the Walton Family Foundation.

There also was a $100,000 gift in August 2008 from the Northwest Arkansas Community Foundation, a group whose mission is encouraging philanthropy across the region.

In addition to the private support, the UAMS satellite campus is expected to receive $3 million toward operating funds from a tax increase on cigarettes and other tobacco products that took effect March 1.

Arkansas Heart Hospital Awarded 2009 C.A.R.E.S. Designation

Arkansas Heart Hospital is among the first 33 recipients in the nation to have earned the prestigious Medical Partners International 2009 C.A.R.E.S. Designation.

The C.A.R.E.S. (Compassion, Attitude, Respect, Environment and Service) Designation places Arkansas Heart Hospital in the top one percent of all healthcare organizations in the United States.

This accomplishment was based on information provided through HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) for the 12-month time period ending December 2007. HCAHPS is a nationally standardized survey developed by CMS and AHRQ for measuring how patients perceive the care they receive in hospitals. The survey is intended to inform hospital managers and caregivers, among others, what patients think of their hospital care.

This award is based on outstanding performance within the hospital. Fields considered in the decision include: nurse care, doctor care, dietician care, and environmental service group care. All these fields within the Arkansas Heart Hospital have worked together to help the hospital consistently score within the top 1% in the nation in patient satisfaction.